EDITORIAL: Results of Scotia Surgery deal should be public

Some debates Canadians are universally tired of. The national unity question, for example, has become as dull to Quebecers as it is to their compatriots in, say, Kentville.

But some debates we never seem to tire of — such as turning public vs. private health care into a kind of national identity question.

So it’s not surprising the provincial NDP government’s plan to renew a contract with a private Dartmouth firm, to perform hundreds of publicly insured orthopedic surgeries, still has the power to excite passions.

Critics like the Nova Scotia Citizens’ Health Care Network and the Council of Canadians have argued on these pages the Scotia Surgery model is fool’s gold, that such clinics must either be charging more or reducing the quality of care, and that they inevitably divert human resources away from the public system.

Surgeon Gerald Reardon, who operates in both the public and private theatres, has countered persuasively that this is in fact a “successful public-private partnership,” that he performs procedures at Scotia Surgery in 60 per cent less time, at lower cost, with similar health outcomes and without reducing the number of operations he performs at the hospital.

It would be helpful if the Dexter government, which has gone from basher to backer of the Scotia Surgery contract it inherited from a Tory administration, laid out the case for the private-clinic approach in better detail, beyond the whittling down of wait lists. If it has evidence, which it must, that, pound for pound, this delivery model is more advantageous, it should produce it so taxpayers can judge.

Arrangements like this should be evaluated on actual results, not on whether they detract, in the abstract, from some ideal of public delivery. The firm, which also specializes in oral and plastic surgeries, seems to have honed the art of executing simple orthopedic operations at a competitive price. More complex procedures like hip replacements are still done in hospital by the same professionals. Either way, the patient is covered and universal access preserved.

For-profit clinics that perform publicly insured procedures are often viewed as creeping Americanization. But the fact is they tend to operate in niches, or narrowly focused medical fields, and don’t represent wholesale competition to the public system. If such clinics are properly integrated into that system — as Scotia Surgery seems to be — the relationship between the private and the public is not antagonistic, but symbiotic. That is to say, everybody wins: the taxpayer, the patient and the doctor.